S289: MOTIVATORS AND BARRIERS TO BLOOD DONATION AMONG POTENTIAL DONORS OF AFRICAN AND CAUCASIAN ETHNICITY
Authors: H. Fogarty, M. Sardana, L. Sheridan, P. Chieng, S. Kelly, N. Ngwenya, C. Sheehan, K. Morris, E. Tuohy
Journal: HemaSphere (2022)

Background: Blood donors of minority ethnicity, especially those of African origin, are under-represented in many high-income Western countries, including in Ireland. Conversely, the rising number of patients with Sickle Cell Disease (SCD) in many European countries has resulted in increased demand for blood transfusion. Given the high risk of alloimmunization among haemoglobinopathy patients, extended red blood cell matching is now recommended. To increase the probability of a phenotypic match, donors and recipients should share the same racial and/or ethnic background. Hence, the discrepancy between the number of African blood donors and the number of SCD patients is creating a strain on the blood supply chain and recruitment of African donors has become a major priority for transfusion services worldwide. Aims: A key step towards enhancing recruitment of blood donors is to first understand perceived barriers and facilitators to blood donation, which may differ across different demographic categories, including ethnicity. This study aims to explore 1) Barriers and 2) Motivators to blood donation and 3) Awareness of SCD among potential donors of diverse ethnic backgrounds in Ireland. Methods: Following ethical approval, patients attending the National Sickle Cell Disease and Thalassemia service at St James’s Hospital, Dublin, were invited to share an anonymous, online, 33-item survey within their local communities to achieve snowball-sampling. Inclusion criteria were adults aged ≥18 years who had not previously donated blood in Ireland. Participants were asked to state their age, sex and ethnicity. Responses for each survey item were recorded on a four-point Likert scale: Strongly Agree, Agree, Disagree or Strongly Disagree. Survey data were collected from August-December 2021. Statistical analysis was conducted using GraphPad Prism 9.1 (GraphPad Software Inc., USA). Results: 387 respondents completed the survey, including 311 non-donors (median age 25 years, 67% female). Ethnic backgrounds included: African (59%), Caucasian (25%), Asian (8%), Hispanic/Latino (3%), Middle Eastern (3%) and Multiracial (2%). The most common barrier overall was lack of information on blood donation, identified by 60%. African respondents were 3 times more likely to report lack of information (OR 3.1 CI 1.8-5.3, p<0.0001) and 5 times more likely to report malaria-related barriers than Caucasians (OR 5.1 CI 2.1-12.3, p=0.0002). Conversely, Caucasians were twice as likely to report fear of needles/pain (OR 2.1, CI 1.1-3.7, p=0.02). Motivators also varied by ethnicity, with African respondents 9 times more likely to donate to help someone within their own community (OR 9.3 CI 4.6-18.3, p<0.00001) and 5 times more likely to donate for religious motivators (OR 5.5 CI 2.9-10.4 p<0.0001) than Caucasians. Awareness of SCD was 5 times higher among African respondents (92% versus 66%, OR 5.3 CI 2.7-10.5, p<0.0001). Summary/Conclusion: This study enhances our understanding of ethnic differences in barriers and motivators to blood donation. While some barriers are shared across ethnic groups, including lack of information, notable differences exist between Caucasian and African respondents. Given that many European countries experience difficulties in the provision of phenotypically matched blood for SCD patients, these data provide valuable insights to inform future campaigns aimed at recruitment of African donors. At a time when the importance of diversity and inclusivity are increasingly recognized in society, enhancing ethnic diversity in blood donors may reflect a positive force for healthcare and social equality.